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The NHS must stop turning a "blind eye" to smoking and ban it in all hospital grounds in England, according to new guidance.

The National Institute for Health and Care Excellence said it wanted to see smoking shelters scrapped so patients, visitors and staff could not light up.

Staff should also stop helping patients out of their beds to go for a smoke.

And patients who smoke must be identified and offered help to quit, the guidance added.

It said nurses, doctors and other staff could give brief advice and then refer smokers on to NHS stopping smoking services.

Smoking rates are particularly high among mental health patients with one in three smoking, rising to 70% in psychiatric units.

That compares with the one in five among the general population who are smokers.

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How one hospital in Cambridge has struggled to stub out smoking

The guidance, which is voluntary for the NHS to follow, even suggested staff caught smoking should be disciplined.

'Too long'

The National Institute for Health and Care Excellence (NICE) conceded some parts of the NHS had already adopted these approaches, but said the idea of the guidance was to make sure it became consistent across the health service.

NICE public health director Prof Mike Kelly said the NHS had turned a "blind eye" for too long.

"It has been tolerated by the NHS and it is high time that stopped.

"NHS hospitals and staff have a duty of care to protect the health of people who use or work in their services.

"We need to end the terrible spectacle of people on drips in hospital gowns smoking outside hospital entrances."

In practice, he said, doctors and nurses could provide nicotine replacement therapies and advise patients about counselling to ensure they were not "going up the wall" with nicotine cravings.

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He acknowledged that stopping a determined smoker from going outside to light up was "clearly very difficult".

"This is not about imposing some sort of penal regime in which doctors, nurses, administrators spend all their time trying to enforce a series of rules and regulations."

He said it was about a culture shift and removing smoking shelters would help eliminate any subliminal message that it was ok to smoke around a hospital.

Stress relief

Stephen Dalton, of the NHS Confederation, which represents NHS trusts, said the guidance was welcome.

"A total ban on smoking complements the duty of care on healthcare staff and the organisation to protect the health of people in their care and promote healthy behaviour."

Dr John Moore-Gillon, a lung specialist, said there was no doubt that smoking rates fell in environments where it was banned, pointing to smoking bans in pubs, clubs and public buildings.

"And they're actually more likely to give up smoking if they're given this advice when they're in a hospital or other health care setting," he added.

But Simon Clark, of smokers' lobby group Forest, said: "NHS staff have a duty of care to protect people's health, but that doesn't include the right to nag, cajole or bully smokers to quit.

"Tobacco is a legal product and a lot of people smoke to relieve stress.

"It's not only heartless and inhumane to ban patients from smoking outside hospitals and clinics, it's almost impossible to enforce without installing CCTV cameras and employing wardens to monitor the grounds."

Comment number 969.

Stuart27th November 2013 - 16:18

Surely the answer here is simple; ban all tobacco products. I am a smoker and I enjoy smoking; it's a legal, heavily taxed habbit. The reality is that taxation from tobacco is significantly higher than any cost associated with the treatment of smoking related illness; hence why the Government will not ban it. If you want to be serious about banning smoking, stop messing about and ban it.

Comment number 965.

paul27th November 2013 - 16:22

Sheer froth, I would be more impressed if they got people out of corridors, gave them sensitive and compassionate care and kept the wards clean.They can bother about whether the Janitor nipped out for a tab when they get the important things right.

Comment number 964.

koz27th November 2013 - 16:19

912.JM And you've got plenty...... in your............ better not, BBC mediators may accuse me of breaking house rules again.... little non smoking angels that they must be. What a waste of time! One way Blog!¦:-((

Comment number 963.

mm27th November 2013 - 16:17

The big problem is that (unlike GP surgeries) hospitals do little or nothing to educate smokers or to seriously inconvenience them. Even handing out leaflets would be a step forward. I know a hospital that even has a garden for smokers.

Comment number 962.

mickmorpeth27th November 2013 - 16:16

I wish the government would do something about passive whinging, it's adversely affecting my well being constantly exposed to pompous self promoting moaners with so little substance to their own miserable lives that they have to impinge on other people's lives just to give them some sort of justification for the space they take up.

Comment number 958.

omegaman27th November 2013 - 16:08

Consider this, there are nicotine addicts within NHS, Police, Charities, soldiers (fighting for liberty!), scientists, the Church, fire service, in fact every walk of life. Their only mistake was lighting their first cigarette. After that, they all became addicted to nicotine. It does not make them deserving of vilification from those on "high horses". No one is perfect, even non smokers.

Comment number 955.

JM27th November 2013 - 16:01

952. epipeman that's right mate cigarettes are pure tobacco, keep thinking that each time you put one of those cancer sticks in your mouth. I can name all 599 of the 'approved' chemicals, sit back light up a ciggie and I will tell you.

Comment number 953.

scottycam27th November 2013 - 15:57

940. Muggs375Smoking 4 cigarettes in a single hour and driving wont effect your ability to drive, or working on heavy machinery. They are not alike in anyway.

938. TonyHOK would you also be in favour of smokers reducing the taxes provided to the NHS £10 billion per annum. Is the person involved in dangerous sports who has surgery every year more or less deserving, the boxer, the wrestler?

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